Turning back the clock on ageing used to mean going under the knife and a few weeks in purdah while the scars healed. "Lunch-time facelifts" have changed all that. There's no "down-time" with the non-invasive, non-surgical cosmetic treatments developed in the past five years. You can have a procedure done in an hour.
Having consulted leading doctors in the field and seen what's on offer, in my view there are five worthwhile medical treatments for those who want younger-looking, smoother skin: Photorejuvenation, Botox injections, hyaluronic acid injections, chemical peels and Dermagenesis Particle Skin Resurfacing.
These are all medical interventions - not spa treatments or beauty facials. So they should be administered only by highly experienced practitioners.
The treatments are as expensive as they are effective. You can spend as much money erasing the effects of the sun as you did on the holidays which damaged your skin in the first place. Pale, delicate Irish skin takes sun badly. So without the dedicated use of sunblock, it absorbs more harmful ultraviolet radiation more quickly than, say, the Spanish skin. Pigmented agespots, fine wrinkling and red thread-veins inevitably result and can be apparent even before the age of 30.
"Most Irish adults today are more sun-damaged than their parents' generation," says Dr Kate Coleman-Moriarty, consultant eye, oculoplastic and skin laser surgeon in the Blackrock Clinic. "This is the first generation that can afford holidays abroad in the summer." So people are cooking themselves to death in the sun."
Ironically, light can erase the damage caused by light. Photorejuvenation was developed to repair the reddened, blotchy skins of sun-baked IrishAmericans by Dr Robert Weiss, Associate Professor Dermatology at Johns Hopkins University School of Medicine and the Maryland Laser, Skin and Vein Institute. Working in cooperation with the FDA (Federal Food and Drug Administration) and ESL Sharplan, an Israeli medical laser manufacturer, he has found a way of repairing the skin without removing the upper layer. Dr Weisss sees his method as replacing laser skin resurfacing, which involves a couple of days of down-time, strips the top layer of skin and can result in an unnaturally white complexion. Photorejuvenation achieves an 85 per cent simultaneous improvement on skin pigmentation marks, broken veins, redness (rosacea and flushing), mild acne scars, irregular texture, birth marks, open pores and unwanted hair - a claim backed up by the FDA and by peer-reviewed medical research. Dr Weiss demonstrated Photorejuvenation at the Dermalaser Clinic in Blackrock, Co Dublin. He used intense pulsed light technology (IPL), in which broad-spectrum light is flashed through a quartz crystal against the skin.
As the light passes through the crystal, it is converted to heat which is absorbed by the redness of veins or the melanin in pigmentation, destroying the target without damaging healthy surrounding skin. All the patient feels is heat and mild stinging.
While fading the bad, photo rejuvenation stimulates the good by inducing collagen production beneath the skin. Collagen is the material that makes skin elastic and firm. We have less of it as we get older. When collagen plumps in response to the light, it creates a 25-50 per cent improvement in the depth of fine lines.
To get a realistic view of the results, you have to see "after" photographs taken four weeks after the first treatment, because by that time collagen has built up. For the full effect, most people need between four and six treatments - at £400 a go and spaced three weeks apart.
Dr Weiss's own medical photographs are impressive: a man with skin so red with broken capillaries that people mistook him for an alcoholic, was restored to a normal colour. A woman whose face was covered in age spots from the sun, got back a creamy complexion. Another method of fading blemishes and improving skin texture is Dermagenesis Particle Skin Resurfacing, practised by Ann Fox, a nurse,in Dun Laoghaire, Co Dublin. The word of mouth on Dermagenesis is so positive that it's a wonder how Fox keeps the celebrities from bumping into each other as they come and go. This method uses a highly controlled spray of fine crystals to remove the outer layer of skin. Particle Skin Resurfacing is effective against blackheads and whiteheads, fine wrinkles, sundamaged skin, acne-prone skin, oily skin and superficial age spots. It takes less than 30 minutes and it doesn't hurt. You can see a difference after the first treatment, but the fullest improvement takes six treatments (£500 total, or £120 each).
Chemical peels are yet another alternative. When glycolic acid or low-strength salicylic acid in gel form is applied to the skin, it gently removes dead surface cells to reveal fresher-looking skin with an improved texture.
"The skin feels brilliant afterwards," says Dr Rosemary Coleman, dermatologist at the Blackrock Clinic, Dublin. "The peel is gentle and superficial, but can be very effective on active acne, blackheads, superficial acne scars, pigmented spots, fine lines, freckles and chloasma (pigmentation which forms during pregnancy). The cost is £120 per treatment.
Improving the texture and appearance of the skin is one thing. Actually eradicating wrinkles is the holy grail of dermatology. The magic potion comes from Westport, Co Mayo - in the form of Botox, the brand name for a type of botulinum toxin manufactured by Allergan and exported around the world. "Of the various `lunch-time' treatments, Botox has by far the most dramatic and immediate effect. You see a patient with a washerboard forehead, and one week later it's gone," says Dr Coleman.
It's hard to believe that a neurotoxin which can cause fatal food poisoning could also have benefits. Botox has been used for decades to prevent involuntary muscle spasms. Its cosmetic benefits were discovered by a Canadian eye doctor and her husband, a dermatologist, who noticed that people injected with Botox to prevent blepherospasm (nervous tics of the eyelid) weren't wrinkling. There are two kinds of wrinkles: fine lines caused by sun damage and deeper lines - called `wrinkles in motion' - caused by facial expression, as muscles move beneath the skin. Botox works by interrupting the signal between nerve and muscle, so that when your brain tells you to squint, squinch your eyebrows together or furrow your forehead, you can't do it.
Without muscle movement to crease the skin, wrinkles disappear. Further wrinkling is prevented. If you are young enough when you start using Botox and stay out of the sun, you will never get wrinkles. During a treatment session, the doctor injects the toxin in eight to 12 places around the eyes and forehead. After about a week, the muscles stop moving and the effect lasts, on average, four to six months. The cost depends on how much Botox you need: a half-vial is £200 and a full vial costs £400.
Botox may be used with hyaluronic acid (brand names: Restylane and Perlane), which is more subtle in its effect than Botox. Hyaluronic acid is a gel injected to replace collagen in the skin, filling in scars and deep lines. While Botox can stop the movement that reinforces the deep lines, hyaluronic acid can plump up the creases, making the lines much less obvious. The cost varies from £190350 depending on how much you need.
These five treatments can complement each other. For the best result, have your skin assessed by a dermatologist or cosmetic surgeon who will counsel you about realistic expectations. Looking "younger" does not mean looking 21, but who'd want to?
Dermalaser Clinics are in Blackrock, Swords and Tallaght - for appointments, call 012788211
Dermagenesis is available at The Skincare Lab Ltd - 012842999
